[mj2903]

Has anyone who has an insurance company that requires the 6 month dr. supervised visits had those visits denied for coverage?

I will be calling on Monday to see what the issue is but it seems strange that they require these visits before approving the surgery but then denied coverage.

Melinda

[decker1976]

Nope I didn't have that experience at all. Good luck.

[4Kate]

Its likely just a blurp. They required me to see a psycholigist and then refused to pay for it threw 2 apeals. Then they required me to have sleep apnea under control and that ment going threw the testing. Well they refused to pay for the second test that was to set the cpap machine. LOL Finnally my DR said the sleep apnea was so mild to just use a machine in the recovery area of the hospital.

My point is if your Drs offfice is a good one they will fight the ins co for you and you can just try and be as patient as possible.

Hang in there!

[MyTurn2009]

I had that happen. When I did a little more checking, and found out that they would not cover the visits (billed at $230.00 each) if it was just for "weight loss surgery", even though they require it. However, as long as there were other reasons checked off in addition to the WLS (things such as high cholesterol - which is fine now thanks to lipitor!), it was covered. So, check with the doctor's office and make sure everything "condition" that applies to you was given to the nutritionist's office, and check with their billing to make sure they noted all conditions that are applicable to you.

[SkinnyMe1342]

My surgeon is one of many that my insurance plans says to go to for surgery. Something like "Bariatric Center of Excellence" which means they meet certain requirements. My insurance says I can only go to one of these centers. So, I only paid co-pays. Might want to check if your insurance covers certain centers or surgeons?

[mj2903]

What is now my primary (don't have the card etc yet) requires that I go to a bariatric center of excellence which I am, my secondary insurance which has the much better coverage has their own 'centers of distinction' according to the policy handbook. It is the secondary policy that requires the 6 months, I hopefully will be able to get some additional information soon on that policy.

I had a good talk with his company on Thursday and feel a lot better. They will pay up to what they would cover in the absence of other primary coverage which for the surgery and hospitalization is just the per admission charge. As long as I try through my primary and they pre-approve then they will cover the surgery even if the primary doesn't.

Thanks for the feedback!!

Melinda